Annals of clinical and translational neurology · 2026
"Low-Positive" MOG-IgG Cases Among Adults With a First Event Suggestive of Multiple Sclerosis.
СтатьяНазвание и аннотация: Перевод в очереди
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Villacieros-Álvarez Javier, Espejo Carmen, Arrambide Georgina, Castillo Mireia, Rodriguez Marta, Ariño Helena, Elosua Iker, Tur Carmen, Vidal-Jordana Angela, Vilaseca Andreu, Castilló Joaquín, Galán Ingrid, Midaglia Luciana, Nos Carlos, Rodríguez-Acevedo Breogan, Zabalza Ana, Bollo Luca, Pappolla Agustín, Carvajal René, Mongay-Ochoa Neus, Rio Jordi, Sastre-Garriga Jaume, Comabella Manuel, Busiello Gesualdina, Sceppacuercia Sofia, Rovira Àlex, Montalban Xavier, Tintoré Mar, Auger Cristina, Cobo-Calvo Álvaro
Аннотация
OBJECTIVE: To determine the prevalence and clinical characteristics of patients with "low-positive" (LP) MOG-IgG (titres 1:160-1:320) among adults with a first demyelinating event (FDE) suggestive of multiple sclerosis (MS).
METHODS: From the Barcelona CIS inception cohort, we included adult patients with serum collected ≤ 6 months from the FDE. MOG-IgG was assessed by a cell-based assay with flow cytometry (CBA-FC). Demographic, clinical, and paraclinical data were compared among seronegative, LP, and "clear-positive" (CP; ≥ 1:640) patients. Supporting MOGAD features and final diagnoses were retrospectively reviewed in seropositive cases.
RESULTS: Of 613 patients, 42 (6.9%) were MOG-IgG positive (CP = 17; LP = 25). LP patients were indistinguishable from seronegative patients but differed from CP patients, who more frequently had optic neuritis, lacked cerebrospinal fluid-oligoclonal bands, and were less likely to meet the McDonald criteria (p < 0.05). At the last follow-up, 64% of LP versus 18% of CP patients were diagnosed with MS (p = 0.004). Only one LP patient fulfilled MOGAD criteria, compared with 14 CP patients (p < 0.001).
INTERPRETATION: Lowering the CBA-FC positivity threshold to ≥ 1:160 had limited diagnostic yield in this MS-predominant cohort, as most LP cases were ultimately diagnosed with MS. These findings support cautious interpretation of LP MOG-IgG results in this clinical setting.
METHODS: From the Barcelona CIS inception cohort, we included adult patients with serum collected ≤ 6 months from the FDE. MOG-IgG was assessed by a cell-based assay with flow cytometry (CBA-FC). Demographic, clinical, and paraclinical data were compared among seronegative, LP, and "clear-positive" (CP; ≥ 1:640) patients. Supporting MOGAD features and final diagnoses were retrospectively reviewed in seropositive cases.
RESULTS: Of 613 patients, 42 (6.9%) were MOG-IgG positive (CP = 17; LP = 25). LP patients were indistinguishable from seronegative patients but differed from CP patients, who more frequently had optic neuritis, lacked cerebrospinal fluid-oligoclonal bands, and were less likely to meet the McDonald criteria (p < 0.05). At the last follow-up, 64% of LP versus 18% of CP patients were diagnosed with MS (p = 0.004). Only one LP patient fulfilled MOGAD criteria, compared with 14 CP patients (p < 0.001).
INTERPRETATION: Lowering the CBA-FC positivity threshold to ≥ 1:160 had limited diagnostic yield in this MS-predominant cohort, as most LP cases were ultimately diagnosed with MS. These findings support cautious interpretation of LP MOG-IgG results in this clinical setting.